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Arterial ulcer

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https://www.readbyqxmd.com/read/28108437/pouch-pseudoaneurysm-a-rare-cause-of-recurrent-haemorrhage-following-ileal-pouch-anal-anastomosis
#1
Hunaid Hatimi, Saket Kumar, Abhijit Chandra, Vishal Gupta
Bleeding following restorative proctocolectomy for chronic ulcerative colitis is an uncommon complication. Usually bleeding occurs from the ileal pouch-anal anastomotic site in the early postoperative period. Significant pouch bleeding in the late postoperative course is rarely encountered. A mesenteric artery pseudoaneurysm along the ileal pouch staple line may be a cause of late-presenting massive per-rectal bleed. Although a rare phenomenon, it must be considered to be a differential in such a situation.
January 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28094314/reassessment-of-rebleeding-risk-of-forrest-ib-oozing-peptic-ulcer-bleeding-in-a-large-international-randomized-trial
#2
Dennis M Jensen, Stefan Eklund, Tore Persson, Henrik Ahlbom, Robert Stuart, Alan N Barkun, Ernest J Kuipers, Joachim Mössner, James Y Lau, Joseph J Sung, Jan Kilhamn, Tore Lind
OBJECTIVES: Our aims were to assess risks of early rebleeding after successful endoscopic hemostasis for Forrest oozing (FIB) peptic ulcer bleeding (PUBs) compared with other stigmata of recent hemorrhage (SRH). METHODS: These were post hoc multivariable analyses of a large, international, double-blind study (NCT00251979) of patients randomized to high-dose intravenous (IV) esomeprazole (PPI) or placebo for 72 h. Rebleeding rates of patients with PUB SRH treated with either PPI or placebo after successful endoscopic hemostasis were also compared...
January 17, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28092221/tuberculosis-mimicking-primary-systemic-vasculitis-not-to-be-missed
#3
Ankit Jain, Durga Prasanna Misra, A Ramesh, Debdatta Basu, Vikramraj K Jain, Vir Singh Negi
Infections are an important differential diagnosis in patients presenting with features of systemic vasculitis. We report a young lady with constitutional features, leg ulcers, digital gangrene and absent peripheral pulses with cervical adenopathy. Chest imaging revealed multiple necrotic lung lesions and involvement of left subclavian artery at its origin from the aorta, Histopathology from cervical lymph nodes showed multiple caseated lymph nodes, which in the context of a positive Mantoux test led us to diagnose tuberculosis and institute appropriate therapy...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28088233/successful-recovery-from-a-subclavicular-ulcer-caused-by-lenvatinib-for-thyroid-cancer-a-case-report
#4
Morimasa Kitamura, Tomomasa Hayashi, Chiaki Suzuki, Shigeru Hirano, Ichiro Tateya, Yo Kishimoto, Koichi Omori
BACKGROUND: There are currently no effective therapeutic methods for locally recurrent, metastatic, or progressive radioactive iodine (RAI)-refractory differentiated thyroid cancer. However, multitargeted tyrosine kinase inhibitors (TKIs) such as lenvatinib or sorafenib have been approved for patients with RAI-refractory differentiated thyroid cancer as a second targeted therapy, and these agents can prolong patient survival. However, several cases have been reported that TKIs have caused fatal complications such as fistula formation or bleeding...
January 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28071288/vulnerable-carotid-plaque-imaging-and-histopathology-without-a-dedicated-mri-receiver-coil
#5
Laura A Fitzpatrick, Nadav Berkovitz, Marlise P Dos Santos, Nevin Majeed, Rafael Glikstein, Santanu Chakraborty, John P Veinot, Grant Stotts, Alain Berthiaume, Robert Chatelain
Stroke is associated with vulnerable carotid artery plaques showing specific histopathologic features, namely a lipid-rich necrotic core, intraplaque hemorrhage, ulceration, and thin fibrous cap. While ultrasound and computed tomography (CT) can identify carotid plaques and determine the extent of stenosis, magnetic resonance imaging (MRI) provides further information regarding plaque composition and morphology. In this feasibility study, three patients with symptomatic, moderately stenosed plaques were imaged with CT angiography (CTA) and MRI (3T and 1...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28062437/dieulafoy-s-lesion-of-the-oesophagus-a-case-series-and-literature-review
#6
Faisal Inayat, Waqas Ullah, Qulsoom Hussain, Abu Hurairah
Dieulafoy's lesion is a vascular abnormality consisting of a tortuous, dilated aberrant submucosal vessel that erodes the overlying mucosal layer without ulceration. The oesophagus is a very rare location for the lesion. Herein, we report a case series of 3 patients who presented with upper gastrointestinal bleeding. Endoscopy was performed, which showed a large calibre-persistent tortuous submucosal artery protruding into the oesophageal lumen. All the patients were successfully managed with endoscopic intervention using epinephrine injection around the lesion followed by hemoclip application...
January 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28060003/clinical-characteristics-of-mixed-arteriovenous-leg-ulcers-a-descriptive-study
#7
Joseph A Marin, Kevin Y Woo
PURPOSE: The purpose of this study was to identify the clinical characteristics of mixed arteriovenous leg ulcers (MLU) that differentiated them from venous leg ulcers (VLU). DESIGN: Secondary analysis of data from larger electronic database. SUBJECTS AND SETTING: The sample comprised 1007 persons with lower extremity ulcers. Two hundred sixty three individuals with MLU were compared to 744 individuals with VLU; their ankle brachial indices were 0...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28056476/-advanced-systemic-sclerosis-endovascular-reconstruction-of-the-aortic-bifurcation-for-limb-salvage
#8
Florian Stein, Lars Kamper, Konstantinos Meletiadis, Ulrich Kusenack, Patrick Haage
History and admission findings A 69-year-old patient was initially hospitalized because of a 1.5 cm ulceration at the back of the right foot which had existed for the last year and become increasingly swollen and painful. Medical history revealed PmScl-positive systemic sclerosis presenting with a massive calcinosis cutis, advanced pulmonary fibrosis and peripheral artery disease. Examinations Inflammatory markers were normal. MR-Angiography of the lower extremities revealed a multi-segmental high-grade stenosis of the aortic bifurcation due to extensively calcified plaques...
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28054925/the-wound-trend-scale-a-retrospective-review-of-utility-and-predictive-value-in-the-assessment-and-documentation-of-lower-leg-ulcers
#9
Noreen A Campbell, Donna L Campbell, Andrea Turner
Wound assessment is essential to manage wound care. The Wound Trend Scale (WTS) is a paper-and-pen instrument comprised of 14 parameters designed to guide assessment of findings relevant to lower leg ulcer management and includes an infection screen and cues for physician consultation. To determine its clinical utility, predictive value, and reliability, data were retrospectively analyzed from a random sampling of medical records of patients seen at a Foot and Leg Clinic between January 1, 2007 and December 31, 2008...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/28047827/su-c-204-01-a-dosimetric-investigation-into-the-effects-of-yttrium-90-radioembolization-on-the-gi-tract-in-vivo-and-histological-analysis-in-an-animal-model
#10
A Pasciak, L Nodit, A Bourgeois, B Paxton, A Arepally, Y Bradley
PURPOSE: In Yttrium-90 (90Y) radioembolization, non-target embolization (NTE) to the stomach or small bowel can result in ulceration, a rare but difficult to manage clinical complication. However, dosimetric thresholds for toxicity to these tissues from radioembolization have never been evaluated in a controlled setting. We performed an analysis of the effect of 90Y radioembolization in a porcine model at different absorbed-dose endpoints. METHODS: Under approval of the University of Tennessee IACUC, 6 female pigs were included in this study...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28041815/non-invasive-lower-limb-small-arterial-measures-co-segregate-strongly-with-foot-complications-in-people-with-diabetes
#11
Sean Michael Lanting, Stephen M Twigg, Nathan Anthony Johnson, Michael Kevin Baker, Ian Douglas Caterson, Vivienne Helaine Chuter
AIMS: It is unclear how well non-invasive lower-limb vascular assessments can identify those at risk of foot complications in people with diabetes. We aimed to investigate the relationship between a history of foot complication (ulceration or amputation) and non-invasive vascular assessments in people with diabetes. METHODS: Bilateral ankle-brachial index (ABI), toe brachial index (TBI) and continuous wave Doppler (CWD) were performed in 127 adults with diabetes (97% type 2; age 66...
November 15, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28034631/emergency-endovascular-management-of-acute-thoracic-aortic-pathology-a-safe-and-feasible-option
#12
Z Ahmed, S M McHugh, A Elmallah, M P Colgan, A O'Callaghan, S M O'Neill, P Madhavan, Z Martin
Endovascular repair has revolutionised the emergency treatment of thoracic aortic disease. We report our 10 year experience using this treatment in emergency cases. A prospectively maintained vascular database was analysed. Patients' medical records and CT images stored on the hospital PACS system were also reviewed. Statistical analysis was done using IBM SPSS V21. There were a total of 59 thoracic aortic stenting procedures of which 33 (60% males with a mean age of 58 yrs) were performed for emergency thoracic pathologies: traumatic transection (n = 10), ruptured aneurysm (n = 6), non-traumatic dissection (n = 8) and penetrating aortic ulcer (n = 9)...
December 27, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28031692/a-case-of-true-brachial-artery-aneurysm-with-severe-left-upper-limb-ischemia
#13
Kengo Nishimura, Takafumi Hamasaki, Syunsuke Fukino
Brachial artery (BA) aneurysms are rare, and most are false aneurysms. Although true BA aneurysms have been reported, most have been reported without symptoms. A 65-year-old man was referred due to a left upper limb mass with rest pain and slight ulceration of the left second and third fingers. As enhanced computed tomography revealed the patency of only the left proximal and distal BA as well as the thrombosed mass, excision of the aneurysm and BA replacement were performed with a great saphenous vein graft...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28031663/cardiovascular-involvement-in-beh%C3%A3-et-disease-clinical-implications
#14
Malka Yahalom, Lev Bloch, Khaled Suleiman, Bar Rosh, Yoav Turgeman
Behçet disease (BD) is a multisystem disorder, with vasculitis as its underlying pathological process, in contrast to the classic triad of recurrent oral and genital ulcerations, with uveitis. Vascular involvement in BD includes venous thrombosis, arterial occlusion, and pulmonary artery and aortic aneurysm formation. Cardiac involvement is rare and often obscure. It includes intracardiac thrombi formation, and is associated with a poor prognosis. Our objectives are to describe two cases with BD, complicated with vascular and cardiac involvement, and to raise awareness of these rare complications, the needed routine surveillance, and thus to prevent inappropriate interventions, serious outcomes, and mortality...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28018832/limited-distal-arch-open-stenting-for-type-b-aortic-dissection-with-an-enlarged-ulcer-like-projection-complicated-by-abdominal-aortic-occlusion
#15
Mitsumasa Hata, Kenji Akiyama, Yukihiko Orime
A 79-year-old man underwent bifurcated graft replacement for abdominal aortic aneurysm, but the graft was totally occluded owing to an acute type B aortic dissection. We could not have access to the root for performing endovascular stenting for dissecting aneurysm. Furthermore, it was difficult to remove the aneurysm via a left thoracotomy because it was impossible to perfuse the lower body with blood from the femoral artery and also a left axillary arterial cannulation was unusable. Herein, we report a patient who was successfully treated with open surgical aortic stenting for an enlarged ulcer-like projection complicated by a type B aortic dissection...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28007772/imaging-carotid-atherosclerosis-plaque-ulceration-comparison-of-advanced-imaging-modalities-and-recent-developments
#16
REVIEW
J Yuan, A Usman, T Das, A J Patterson, J H Gillard, M J Graves
Atherosclerosis remains the leading cause of long-term mortality and morbidity worldwide, despite remarkable advancement in its management. Vulnerable atherosclerotic plaques are principally responsible for thromboembolic events in various arterial territories such as carotid, coronary, and lower limb vessels. Carotid plaque ulceration is one of the key features associated with plaque vulnerability and is considered a notable indicator of previous plaque rupture and possible future cerebrovascular events. Multiple imaging modalities have been used to assess the degree of carotid plaque ulceration for diagnostic and research purposes...
December 22, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28004166/anti-angiotensin-ii-type-1-receptor-autoantibodies-at1r-aas-in-patients-with-systemic-sclerosis-lack-of-association-with-disease-manifestations
#17
Ufuk İlgen, Müçteba Enes Yayla, Nurşen Düzgün
Angiotensin II type 1 receptor autoantibodies (AT1R-AAs) are known to be associated with malignant hypertension, preeclampsia, and vascular rejection in kidney transplantation. They were also suspected to have pathogenetic role in vasculopathic changes in systemic sclerosis (SSc). Clinical data regarding AT1R-AAs in SSc are scarce. In this work, we will examine the relationship between serum levels of AT1R-AAs and disease manifestations. Serum samples from SSc patients and healthy controls were analyzed for AT1R-AAs by using a commercial ELISA kit...
December 21, 2016: Rheumatology International
https://www.readbyqxmd.com/read/28002540/gallbladder-carcinoma-a-rare-cause-of-pyloric-duodenal-stenosis
#18
Zizi Niculescu, Victoria Ulmeanu, Mihaela Maria Ghinea, Liliana Mocanu, Costin Niculescu, Mircea Grigorian
Pyloric duodenal stenosis is usually caused by pyloric, juxtapyloric or duodenal ulcer, or by postbulbar ulcer. Gallbladder cancer (GBC), duodenal diverticula, annular pancreas and superior mesenteric artery syndrome (Wilkie's syndrome) are rare causes of pyloric duodenal stenosis. The case of a 66-year-old female patient is presented. The patient was admitted to hospital presenting anorexia, repeated alimentary vomiting, epigastric pain, and weight loss. Objective clinical examination upon admission: clapotage à jeun is present, triggered by tapping the epigastric region...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28001292/predictors-for-unplanned-hospitalization-of-new-home-care-clients
#19
Jukka K Rönneikkö, Matti Mäkelä, Esa R Jämsen, Heini Huhtala, Harriet Finne-Soveri, Anja Noro, Jaakko N Valvanne
OBJECTIVES: To identify factors predicting unplanned hospitalization of new home care clients using the Resident Assessment Instrument for Home Care (RAI-HC). DESIGN: A register-based study based on RAI-HC assessments and nationwide hospital discharge records. SETTING: Municipal home care services in Finland. PARTICIPANTS: New Finnish home care clients aged 63 and older (N = 15,700). MEASUREMENTS: Information from home care clients' first RAI-HC assessment was connected to information regarding their first hospitalization over 1 year of follow-up...
December 21, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27993523/diabetic-foot-ulcer-severity-predicts-mortality-among-veterans-with-type-2-diabetes
#20
Meghan B Brennan, Timothy M Hess, Brian Bartle, Jennifer M Cooper, Jonathan Kang, Elbert S Huang, Maureen Smith, Min-Woong Sohn, Christopher Crnich
AIM: Diabetic foot ulcers are associated with an increased risk of death. We evaluated whether ulcer severity at presentation predicts mortality. METHODS: Patients from a national, retrospective, cohort of veterans with type 2 diabetes who developed incident diabetic foot ulcers between January 1, 2006 and September 1, 2010, were followed until death or the end of the study period, January 1, 2012. Ulcers were characterized as early stage, osteomyelitis, or gangrene at presentation...
December 10, 2016: Journal of Diabetes and its Complications
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